|
PR BEDSIDE DRAINAGE BAG
|
Professional
|
Both
|
$15.00
|
|
|
Service Code
|
HCPCS A4357
|
| Min. Negotiated Rate |
$4.51 |
| Max. Negotiated Rate |
$19.93 |
| Rate for Payer: Aetna Commercial |
$18.55
|
| Rate for Payer: Aetna Medicare |
$13.84
|
| Rate for Payer: BCBS Complete |
$6.00
|
| Rate for Payer: BCBS MAPPO |
$13.84
|
| Rate for Payer: BCN Commercial |
$13.25
|
| Rate for Payer: BCN Medicare Advantage |
$13.84
|
| Rate for Payer: Cash Price |
$12.00
|
| Rate for Payer: Cash Price |
$12.00
|
| Rate for Payer: Cofinity Commercial |
$18.55
|
| Rate for Payer: Cofinity Commercial |
$19.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.84
|
| Rate for Payer: Healthscope Commercial |
$16.61
|
| Rate for Payer: Healthscope Whirlpool |
$16.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$15.22
|
| Rate for Payer: Nomi Health Commercial |
$16.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.25
|
| Rate for Payer: PACE SWMI |
$13.84
|
| Rate for Payer: PHP Medicare Advantage |
$13.84
|
| Rate for Payer: Priority Health Medicare |
$13.84
|
| Rate for Payer: Railroad Medicare Medicare |
$13.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4.51
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$13.84
|
| Rate for Payer: UHC Exchange |
$4.51
|
| Rate for Payer: UHCCP DNSP |
$13.84
|
|
|
PR BEHAV ASSMT W/SCORE & DOCD/STAND INSTRUMENT
|
Professional
|
Both
|
$11.00
|
|
|
Service Code
|
HCPCS 96127
|
| Min. Negotiated Rate |
$4.65 |
| Max. Negotiated Rate |
$8.89 |
| Rate for Payer: Aetna Commercial |
$6.23
|
| Rate for Payer: Aetna Medicare |
$4.65
|
| Rate for Payer: BCBS MAPPO |
$4.65
|
| Rate for Payer: BCN Commercial |
$6.98
|
| Rate for Payer: BCN Medicare Advantage |
$4.65
|
| Rate for Payer: Cash Price |
$8.80
|
| Rate for Payer: Cash Price |
$8.80
|
| Rate for Payer: Cofinity Commercial |
$6.23
|
| Rate for Payer: Cofinity Commercial |
$6.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.65
|
| Rate for Payer: Healthscope Commercial |
$5.58
|
| Rate for Payer: Healthscope Whirlpool |
$5.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.88
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.12
|
| Rate for Payer: Nomi Health Commercial |
$5.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8.25
|
| Rate for Payer: PACE SWMI |
$4.65
|
| Rate for Payer: PHP Medicare Advantage |
$4.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$8.89
|
| Rate for Payer: Priority Health Medicare |
$4.65
|
| Rate for Payer: Priority Health Narrow Network |
$8.89
|
| Rate for Payer: Railroad Medicare Medicare |
$4.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7.49
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$4.65
|
| Rate for Payer: UHC Exchange |
$7.49
|
| Rate for Payer: UHCCP DNSP |
$4.65
|
|
|
PR BEHAV HLTH DAY TREAT, PER HR
|
Professional
|
Both
|
$567.00
|
|
|
Service Code
|
HCPCS H2012
|
| Min. Negotiated Rate |
$39.28 |
| Max. Negotiated Rate |
$425.25 |
| Rate for Payer: Aetna Commercial |
$39.28
|
| Rate for Payer: BCBS Complete |
$226.80
|
| Rate for Payer: Cash Price |
$453.60
|
| Rate for Payer: Cash Price |
$453.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$425.25
|
|
|
PR BEHAVIORAL & QUALIT ANALYSIS VOICE AND RESONANCE
|
Professional
|
Both
|
$185.00
|
|
|
Service Code
|
HCPCS 92524
|
| Min. Negotiated Rate |
$105.82 |
| Max. Negotiated Rate |
$164.34 |
| Rate for Payer: Aetna Commercial |
$141.80
|
| Rate for Payer: Aetna Medicare |
$105.82
|
| Rate for Payer: BCBS MAPPO |
$105.82
|
| Rate for Payer: BCN Commercial |
$164.34
|
| Rate for Payer: BCN Medicare Advantage |
$105.82
|
| Rate for Payer: Cash Price |
$148.00
|
| Rate for Payer: Cash Price |
$148.00
|
| Rate for Payer: Cofinity Commercial |
$141.80
|
| Rate for Payer: Cofinity Commercial |
$152.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$105.82
|
| Rate for Payer: Healthscope Commercial |
$126.98
|
| Rate for Payer: Healthscope Whirlpool |
$126.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$111.11
|
| Rate for Payer: Molina Medicare/Medicaid |
$116.40
|
| Rate for Payer: Nomi Health Commercial |
$126.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$138.75
|
| Rate for Payer: PACE SWMI |
$105.82
|
| Rate for Payer: PHP Medicare Advantage |
$105.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$151.55
|
| Rate for Payer: Priority Health Medicare |
$105.82
|
| Rate for Payer: Priority Health Narrow Network |
$151.55
|
| Rate for Payer: Railroad Medicare Medicare |
$105.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$143.90
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$105.82
|
| Rate for Payer: UHC Exchange |
$143.90
|
| Rate for Payer: UHCCP DNSP |
$105.82
|
|
|
PR BEHAVIORAL VERIFICATION OF AMPLIFICATION
|
Professional
|
Both
|
$32.00
|
|
|
Service Code
|
HCPCS 92638
|
| Min. Negotiated Rate |
$12.80 |
| Max. Negotiated Rate |
$24.00 |
| Rate for Payer: BCBS Complete |
$12.80
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.00
|
|
|
PR BEHAVIOR COUNSEL OBESITY 15M
|
Professional
|
Both
|
$46.00
|
|
|
Service Code
|
HCPCS G0447
|
| Min. Negotiated Rate |
$18.40 |
| Max. Negotiated Rate |
$44.81 |
| Rate for Payer: Aetna Commercial |
$35.00
|
| Rate for Payer: Aetna Medicare |
$26.12
|
| Rate for Payer: BCBS Complete |
$18.40
|
| Rate for Payer: BCBS MAPPO |
$26.12
|
| Rate for Payer: BCN Commercial |
$44.81
|
| Rate for Payer: BCN Medicare Advantage |
$26.12
|
| Rate for Payer: Cash Price |
$36.80
|
| Rate for Payer: Cash Price |
$36.80
|
| Rate for Payer: Cofinity Commercial |
$37.61
|
| Rate for Payer: Cofinity Commercial |
$35.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.12
|
| Rate for Payer: Healthscope Commercial |
$31.34
|
| Rate for Payer: Healthscope Whirlpool |
$31.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$28.73
|
| Rate for Payer: Nomi Health Commercial |
$31.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$34.50
|
| Rate for Payer: PACE SWMI |
$26.12
|
| Rate for Payer: PHP Medicare Advantage |
$26.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$27.23
|
| Rate for Payer: Priority Health Medicare |
$26.12
|
| Rate for Payer: Priority Health Narrow Network |
$27.23
|
| Rate for Payer: Railroad Medicare Medicare |
$26.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$38.00
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$26.12
|
| Rate for Payer: UHC Exchange |
$38.00
|
| Rate for Payer: UHCCP DNSP |
$26.12
|
|
|
PR BEHAVIOR ID ASSESSMENT BY PHYS/QHP EA 15 MIN
|
Professional
|
Both
|
$64.00
|
|
|
Service Code
|
HCPCS 97151
|
| Min. Negotiated Rate |
$20.79 |
| Max. Negotiated Rate |
$79.55 |
| Rate for Payer: Aetna Commercial |
$20.79
|
| Rate for Payer: BCBS Complete |
$25.60
|
| Rate for Payer: BCN Commercial |
$42.82
|
| Rate for Payer: Cash Price |
$51.20
|
| Rate for Payer: Cash Price |
$51.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$48.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$67.51
|
| Rate for Payer: Priority Health Narrow Network |
$67.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$79.55
|
| Rate for Payer: UHC Exchange |
$79.55
|
|
|
PR BETAMETHASONE ACET&SOD PHOSP
|
Professional
|
Both
|
$10.00
|
|
|
Service Code
|
HCPCS J0702
|
| Min. Negotiated Rate |
$1.61 |
| Max. Negotiated Rate |
$10.04 |
| Rate for Payer: Aetna Commercial |
$9.34
|
| Rate for Payer: Aetna Medicare |
$6.97
|
| Rate for Payer: BCBS MAPPO |
$6.97
|
| Rate for Payer: BCBS Trust/PPO |
$1.61
|
| Rate for Payer: BCN Commercial |
$4.80
|
| Rate for Payer: BCN Medicare Advantage |
$6.97
|
| Rate for Payer: Cash Price |
$8.00
|
| Rate for Payer: Cash Price |
$8.00
|
| Rate for Payer: Cofinity Commercial |
$9.34
|
| Rate for Payer: Cofinity Commercial |
$10.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.97
|
| Rate for Payer: Healthscope Commercial |
$8.36
|
| Rate for Payer: Healthscope Whirlpool |
$8.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.32
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.67
|
| Rate for Payer: Nomi Health Commercial |
$8.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7.50
|
| Rate for Payer: PACE SWMI |
$6.97
|
| Rate for Payer: PHP Medicare Advantage |
$6.97
|
| Rate for Payer: Priority Health Medicare |
$6.97
|
| Rate for Payer: Railroad Medicare Medicare |
$6.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6.91
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$6.97
|
| Rate for Payer: UHC Exchange |
$6.91
|
| Rate for Payer: UHCCP DNSP |
$6.97
|
|
|
PR BFB TRAING W/EMG &/MANOMETRY 1ST 15 MIN CNTCT
|
Professional
|
Both
|
$173.00
|
|
|
Service Code
|
HCPCS 90912
|
| Min. Negotiated Rate |
$37.13 |
| Max. Negotiated Rate |
$129.75 |
| Rate for Payer: Aetna Commercial |
$49.75
|
| Rate for Payer: Aetna Medicare |
$37.13
|
| Rate for Payer: BCBS Complete |
$69.20
|
| Rate for Payer: BCBS MAPPO |
$37.13
|
| Rate for Payer: BCN Commercial |
$62.75
|
| Rate for Payer: BCN Medicare Advantage |
$37.13
|
| Rate for Payer: Cash Price |
$138.40
|
| Rate for Payer: Cash Price |
$138.40
|
| Rate for Payer: Cofinity Commercial |
$53.47
|
| Rate for Payer: Cofinity Commercial |
$49.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.13
|
| Rate for Payer: Healthscope Commercial |
$44.56
|
| Rate for Payer: Healthscope Whirlpool |
$44.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$38.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$40.84
|
| Rate for Payer: Nomi Health Commercial |
$44.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$129.75
|
| Rate for Payer: PACE SWMI |
$37.13
|
| Rate for Payer: PHP Medicare Advantage |
$37.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$65.04
|
| Rate for Payer: Priority Health Medicare |
$37.13
|
| Rate for Payer: Priority Health Narrow Network |
$65.04
|
| Rate for Payer: Railroad Medicare Medicare |
$37.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$71.68
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$37.13
|
| Rate for Payer: UHC Exchange |
$71.68
|
| Rate for Payer: UHCCP DNSP |
$37.13
|
|
|
PR BIA WHOLE BODY COMPOSITION ASSESSMENT W/I&R
|
Professional
|
Both
|
$33.00
|
|
|
Service Code
|
HCPCS 0358T
|
| Min. Negotiated Rate |
$13.20 |
| Max. Negotiated Rate |
$215.22 |
| Rate for Payer: Aetna Commercial |
$29.66
|
| Rate for Payer: BCBS Complete |
$13.20
|
| Rate for Payer: BCN Commercial |
$22.90
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$215.22
|
| Rate for Payer: UHC Exchange |
$215.22
|
|
|
PR BILATERAL GYNECOMASTIA
|
Professional
|
Both
|
$4,506.00
|
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$1,802.40 |
| Max. Negotiated Rate |
$3,379.50 |
| Rate for Payer: BCBS Complete |
$1,802.40
|
| Rate for Payer: Cash Price |
$3,604.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,379.50
|
|
|
PR BILATERAL MASTOPEXY
|
Professional
|
Both
|
$5,408.00
|
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$2,163.20 |
| Max. Negotiated Rate |
$4,056.00 |
| Rate for Payer: BCBS Complete |
$2,163.20
|
| Rate for Payer: Cash Price |
$4,326.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,056.00
|
|
|
PR BILATERAL OTOPLASTY
|
Professional
|
Both
|
$4,506.00
|
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$1,802.40 |
| Max. Negotiated Rate |
$3,379.50 |
| Rate for Payer: BCBS Complete |
$1,802.40
|
| Rate for Payer: Cash Price |
$3,604.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,379.50
|
|
|
PR BILATERAL REDUCTION MAMMOPLASTY
|
Professional
|
Both
|
$3,992.00
|
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$1,596.80 |
| Max. Negotiated Rate |
$2,994.00 |
| Rate for Payer: BCBS Complete |
$1,596.80
|
| Rate for Payer: Cash Price |
$3,193.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,994.00
|
|
|
PR BILATERAL THORACIC ROLL EXCISION
|
Professional
|
Both
|
$3,605.00
|
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$1,442.00 |
| Max. Negotiated Rate |
$2,703.75 |
| Rate for Payer: BCBS Complete |
$1,442.00
|
| Rate for Payer: Cash Price |
$2,884.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,703.75
|
|
|
PR BILIARY ENDOSCOPY PRQ VIA T-TUBE W/RMVL CALCULUS
|
Professional
|
Both
|
$943.00
|
|
|
Service Code
|
HCPCS 47554
|
| Min. Negotiated Rate |
$252.83 |
| Max. Negotiated Rate |
$923.51 |
| Rate for Payer: Aetna Commercial |
$531.47
|
| Rate for Payer: Aetna Medicare |
$396.62
|
| Rate for Payer: BCBS Complete |
$265.47
|
| Rate for Payer: BCBS MAPPO |
$396.62
|
| Rate for Payer: BCN Commercial |
$659.83
|
| Rate for Payer: BCN Medicare Advantage |
$396.62
|
| Rate for Payer: Cash Price |
$754.40
|
| Rate for Payer: Cash Price |
$754.40
|
| Rate for Payer: Cofinity Commercial |
$571.13
|
| Rate for Payer: Cofinity Commercial |
$531.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$396.62
|
| Rate for Payer: Healthscope Commercial |
$475.94
|
| Rate for Payer: Healthscope Whirlpool |
$475.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$416.45
|
| Rate for Payer: Meridian Medicaid |
$265.47
|
| Rate for Payer: Molina Medicare/Medicaid |
$436.28
|
| Rate for Payer: Nomi Health Commercial |
$475.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$707.25
|
| Rate for Payer: PACE SWMI |
$396.62
|
| Rate for Payer: PHP Medicare Advantage |
$396.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$803.95
|
| Rate for Payer: Priority Health Medicare |
$396.62
|
| Rate for Payer: Priority Health Narrow Network |
$803.95
|
| Rate for Payer: Railroad Medicare Medicare |
$396.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$923.51
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$396.62
|
| Rate for Payer: UHC Exchange |
$923.51
|
| Rate for Payer: UHC Medicaid |
$252.83
|
| Rate for Payer: UHCCP DNSP |
$396.62
|
| Rate for Payer: UHCCP Medicaid |
$252.83
|
|
|
PR BILIARY NDSC INTRAOPERATIVE
|
Professional
|
Both
|
$546.00
|
|
|
Service Code
|
HCPCS 47550
|
| Min. Negotiated Rate |
$92.44 |
| Max. Negotiated Rate |
$409.50 |
| Rate for Payer: Aetna Commercial |
$195.65
|
| Rate for Payer: Aetna Medicare |
$146.01
|
| Rate for Payer: BCBS Complete |
$97.06
|
| Rate for Payer: BCBS MAPPO |
$146.01
|
| Rate for Payer: BCN Commercial |
$241.52
|
| Rate for Payer: BCN Medicare Advantage |
$146.01
|
| Rate for Payer: Cash Price |
$436.80
|
| Rate for Payer: Cash Price |
$436.80
|
| Rate for Payer: Cofinity Commercial |
$210.25
|
| Rate for Payer: Cofinity Commercial |
$195.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$146.01
|
| Rate for Payer: Healthscope Commercial |
$175.21
|
| Rate for Payer: Healthscope Whirlpool |
$175.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$153.31
|
| Rate for Payer: Meridian Medicaid |
$97.06
|
| Rate for Payer: Molina Medicare/Medicaid |
$160.61
|
| Rate for Payer: Nomi Health Commercial |
$175.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$409.50
|
| Rate for Payer: PACE SWMI |
$146.01
|
| Rate for Payer: PHP Medicare Advantage |
$146.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$92.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$294.28
|
| Rate for Payer: Priority Health Medicare |
$146.01
|
| Rate for Payer: Priority Health Narrow Network |
$294.28
|
| Rate for Payer: Railroad Medicare Medicare |
$146.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$296.18
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$146.01
|
| Rate for Payer: UHC Exchange |
$296.18
|
| Rate for Payer: UHC Medicaid |
$92.44
|
| Rate for Payer: UHCCP DNSP |
$146.01
|
| Rate for Payer: UHCCP Medicaid |
$92.44
|
|
|
PR BINOCULAR MICROSCOPY SEPARATE DX PROCEDURE
|
Professional
|
Both
|
$105.00
|
|
|
Service Code
|
HCPCS 92504
|
| Min. Negotiated Rate |
$7.61 |
| Max. Negotiated Rate |
$78.75 |
| Rate for Payer: Aetna Commercial |
$10.20
|
| Rate for Payer: Aetna Medicare |
$7.61
|
| Rate for Payer: BCBS Complete |
$42.00
|
| Rate for Payer: BCBS MAPPO |
$7.61
|
| Rate for Payer: BCN Commercial |
$11.00
|
| Rate for Payer: BCN Medicare Advantage |
$7.61
|
| Rate for Payer: Cash Price |
$84.00
|
| Rate for Payer: Cash Price |
$84.00
|
| Rate for Payer: Cofinity Commercial |
$10.20
|
| Rate for Payer: Cofinity Commercial |
$10.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.61
|
| Rate for Payer: Healthscope Commercial |
$9.13
|
| Rate for Payer: Healthscope Whirlpool |
$9.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$8.37
|
| Rate for Payer: Nomi Health Commercial |
$9.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$78.75
|
| Rate for Payer: PACE SWMI |
$7.61
|
| Rate for Payer: PHP Medicare Advantage |
$7.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$12.86
|
| Rate for Payer: Priority Health Medicare |
$7.61
|
| Rate for Payer: Priority Health Narrow Network |
$12.86
|
| Rate for Payer: Railroad Medicare Medicare |
$7.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$15.30
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$7.61
|
| Rate for Payer: UHC Exchange |
$15.30
|
| Rate for Payer: UHCCP DNSP |
$7.61
|
|
|
PR BIOFEEDBACK PERI/URO/RECTAL
|
Professional
|
Both
|
$194.00
|
|
|
Service Code
|
HCPCS 90911
|
| Min. Negotiated Rate |
$77.60 |
| Max. Negotiated Rate |
$145.50 |
| Rate for Payer: BCBS Complete |
$77.60
|
| Rate for Payer: Cash Price |
$155.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$145.50
|
|
|
PR BIOFEEDBACK TRAINING ANY MODALITY
|
Professional
|
Both
|
$132.00
|
|
|
Service Code
|
HCPCS 90901
|
| Min. Negotiated Rate |
$16.21 |
| Max. Negotiated Rate |
$99.00 |
| Rate for Payer: Aetna Commercial |
$21.72
|
| Rate for Payer: Aetna Medicare |
$16.21
|
| Rate for Payer: BCBS Complete |
$52.80
|
| Rate for Payer: BCBS MAPPO |
$16.21
|
| Rate for Payer: BCN Commercial |
$28.39
|
| Rate for Payer: BCN Medicare Advantage |
$16.21
|
| Rate for Payer: Cash Price |
$105.60
|
| Rate for Payer: Cash Price |
$105.60
|
| Rate for Payer: Cofinity Commercial |
$23.34
|
| Rate for Payer: Cofinity Commercial |
$21.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.21
|
| Rate for Payer: Healthscope Commercial |
$19.45
|
| Rate for Payer: Healthscope Whirlpool |
$19.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$17.83
|
| Rate for Payer: Nomi Health Commercial |
$19.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$99.00
|
| Rate for Payer: PACE SWMI |
$16.21
|
| Rate for Payer: PHP Medicare Advantage |
$16.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$61.18
|
| Rate for Payer: Priority Health Medicare |
$16.21
|
| Rate for Payer: Priority Health Narrow Network |
$61.18
|
| Rate for Payer: Railroad Medicare Medicare |
$16.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$32.43
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$16.21
|
| Rate for Payer: UHC Exchange |
$32.43
|
| Rate for Payer: UHCCP DNSP |
$16.21
|
|
|
PR BIOPSY BONE OPEN DEEP
|
Professional
|
Both
|
$1,302.00
|
|
|
Service Code
|
HCPCS 20245
|
| Min. Negotiated Rate |
$193.40 |
| Max. Negotiated Rate |
$976.50 |
| Rate for Payer: Aetna Commercial |
$403.97
|
| Rate for Payer: Aetna Medicare |
$301.47
|
| Rate for Payer: BCBS Complete |
$203.07
|
| Rate for Payer: BCBS MAPPO |
$301.47
|
| Rate for Payer: BCN Commercial |
$511.92
|
| Rate for Payer: BCN Medicare Advantage |
$301.47
|
| Rate for Payer: Cash Price |
$1,041.60
|
| Rate for Payer: Cash Price |
$1,041.60
|
| Rate for Payer: Cofinity Commercial |
$434.12
|
| Rate for Payer: Cofinity Commercial |
$403.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$301.47
|
| Rate for Payer: Healthscope Commercial |
$361.76
|
| Rate for Payer: Healthscope Whirlpool |
$361.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$316.54
|
| Rate for Payer: Meridian Medicaid |
$203.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$331.62
|
| Rate for Payer: Nomi Health Commercial |
$361.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$976.50
|
| Rate for Payer: PACE SWMI |
$301.47
|
| Rate for Payer: PHP Medicare Advantage |
$301.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$193.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$547.23
|
| Rate for Payer: Priority Health Medicare |
$301.47
|
| Rate for Payer: Priority Health Narrow Network |
$547.23
|
| Rate for Payer: Railroad Medicare Medicare |
$301.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$615.75
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$301.47
|
| Rate for Payer: UHC Exchange |
$615.75
|
| Rate for Payer: UHC Medicaid |
$193.40
|
| Rate for Payer: UHCCP DNSP |
$301.47
|
| Rate for Payer: UHCCP Medicaid |
$193.40
|
|
|
PR BIOPSY BONE OPEN SUPERFICIAL
|
Professional
|
Both
|
$562.00
|
|
|
Service Code
|
HCPCS 20240
|
| Min. Negotiated Rate |
$80.73 |
| Max. Negotiated Rate |
$421.50 |
| Rate for Payer: Aetna Commercial |
$167.66
|
| Rate for Payer: Aetna Medicare |
$125.12
|
| Rate for Payer: BCBS Complete |
$84.77
|
| Rate for Payer: BCBS MAPPO |
$125.12
|
| Rate for Payer: BCN Commercial |
$209.15
|
| Rate for Payer: BCN Medicare Advantage |
$125.12
|
| Rate for Payer: Cash Price |
$449.60
|
| Rate for Payer: Cash Price |
$449.60
|
| Rate for Payer: Cofinity Commercial |
$180.17
|
| Rate for Payer: Cofinity Commercial |
$167.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$125.12
|
| Rate for Payer: Healthscope Commercial |
$150.14
|
| Rate for Payer: Healthscope Whirlpool |
$150.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$131.38
|
| Rate for Payer: Meridian Medicaid |
$84.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$137.63
|
| Rate for Payer: Nomi Health Commercial |
$150.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$421.50
|
| Rate for Payer: PACE SWMI |
$125.12
|
| Rate for Payer: PHP Medicare Advantage |
$125.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$80.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$223.59
|
| Rate for Payer: Priority Health Medicare |
$125.12
|
| Rate for Payer: Priority Health Narrow Network |
$223.59
|
| Rate for Payer: Railroad Medicare Medicare |
$125.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$257.52
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$125.12
|
| Rate for Payer: UHC Exchange |
$257.52
|
| Rate for Payer: UHC Medicaid |
$80.73
|
| Rate for Payer: UHCCP DNSP |
$125.12
|
| Rate for Payer: UHCCP Medicaid |
$80.73
|
|
|
PR BIOPSY BONE TROCAR/NEEDLE DEEP
|
Professional
|
Both
|
$1,976.00
|
|
|
Service Code
|
HCPCS 20225
|
| Min. Negotiated Rate |
$72.21 |
| Max. Negotiated Rate |
$1,482.00 |
| Rate for Payer: Aetna Commercial |
$150.35
|
| Rate for Payer: Aetna Medicare |
$112.20
|
| Rate for Payer: BCBS Complete |
$75.82
|
| Rate for Payer: BCBS MAPPO |
$112.20
|
| Rate for Payer: BCN Commercial |
$191.72
|
| Rate for Payer: BCN Medicare Advantage |
$112.20
|
| Rate for Payer: Cash Price |
$1,580.80
|
| Rate for Payer: Cash Price |
$1,580.80
|
| Rate for Payer: Cofinity Commercial |
$161.57
|
| Rate for Payer: Cofinity Commercial |
$150.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$112.20
|
| Rate for Payer: Healthscope Commercial |
$134.64
|
| Rate for Payer: Healthscope Whirlpool |
$134.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$117.81
|
| Rate for Payer: Meridian Medicaid |
$75.82
|
| Rate for Payer: Molina Medicare/Medicaid |
$123.42
|
| Rate for Payer: Nomi Health Commercial |
$134.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,482.00
|
| Rate for Payer: PACE SWMI |
$112.20
|
| Rate for Payer: PHP Medicare Advantage |
$112.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$72.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$204.94
|
| Rate for Payer: Priority Health Medicare |
$112.20
|
| Rate for Payer: Priority Health Narrow Network |
$204.94
|
| Rate for Payer: Railroad Medicare Medicare |
$112.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$232.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$112.20
|
| Rate for Payer: UHC Exchange |
$232.64
|
| Rate for Payer: UHC Medicaid |
$72.21
|
| Rate for Payer: UHCCP DNSP |
$112.20
|
| Rate for Payer: UHCCP Medicaid |
$72.21
|
|
|
PR BIOPSY BONE TROCAR/NEEDLE SUPERFICIAL
|
Professional
|
Both
|
$358.00
|
|
|
Service Code
|
HCPCS 20220
|
| Min. Negotiated Rate |
$48.78 |
| Max. Negotiated Rate |
$268.50 |
| Rate for Payer: Aetna Commercial |
$101.49
|
| Rate for Payer: Aetna Medicare |
$75.74
|
| Rate for Payer: BCBS Complete |
$51.22
|
| Rate for Payer: BCBS MAPPO |
$75.74
|
| Rate for Payer: BCN Commercial |
$128.97
|
| Rate for Payer: BCN Medicare Advantage |
$75.74
|
| Rate for Payer: Cash Price |
$286.40
|
| Rate for Payer: Cash Price |
$286.40
|
| Rate for Payer: Cofinity Commercial |
$109.07
|
| Rate for Payer: Cofinity Commercial |
$101.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$75.74
|
| Rate for Payer: Healthscope Commercial |
$90.89
|
| Rate for Payer: Healthscope Whirlpool |
$90.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$79.53
|
| Rate for Payer: Meridian Medicaid |
$51.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$83.31
|
| Rate for Payer: Nomi Health Commercial |
$90.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$268.50
|
| Rate for Payer: PACE SWMI |
$75.74
|
| Rate for Payer: PHP Medicare Advantage |
$75.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$48.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$137.88
|
| Rate for Payer: Priority Health Medicare |
$75.74
|
| Rate for Payer: Priority Health Narrow Network |
$137.88
|
| Rate for Payer: Railroad Medicare Medicare |
$75.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$156.01
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$75.74
|
| Rate for Payer: UHC Exchange |
$156.01
|
| Rate for Payer: UHC Medicaid |
$48.78
|
| Rate for Payer: UHCCP DNSP |
$75.74
|
| Rate for Payer: UHCCP Medicaid |
$48.78
|
|
|
PR BIOPSY BREAST OPEN INCISIONAL
|
Professional
|
Both
|
$587.00
|
|
|
Service Code
|
HCPCS 19101
|
| Min. Negotiated Rate |
$138.02 |
| Max. Negotiated Rate |
$440.25 |
| Rate for Payer: Aetna Commercial |
$284.70
|
| Rate for Payer: Aetna Medicare |
$212.46
|
| Rate for Payer: BCBS Complete |
$144.92
|
| Rate for Payer: BCBS MAPPO |
$212.46
|
| Rate for Payer: BCN Commercial |
$338.13
|
| Rate for Payer: BCN Medicare Advantage |
$212.46
|
| Rate for Payer: Cash Price |
$469.60
|
| Rate for Payer: Cash Price |
$469.60
|
| Rate for Payer: Cofinity Commercial |
$305.94
|
| Rate for Payer: Cofinity Commercial |
$284.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$212.46
|
| Rate for Payer: Healthscope Commercial |
$254.95
|
| Rate for Payer: Healthscope Whirlpool |
$254.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$223.08
|
| Rate for Payer: Meridian Medicaid |
$144.92
|
| Rate for Payer: Molina Medicare/Medicaid |
$233.71
|
| Rate for Payer: Nomi Health Commercial |
$254.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$440.25
|
| Rate for Payer: PACE SWMI |
$212.46
|
| Rate for Payer: PHP Medicare Advantage |
$212.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$138.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$309.47
|
| Rate for Payer: Priority Health Medicare |
$212.46
|
| Rate for Payer: Priority Health Narrow Network |
$309.47
|
| Rate for Payer: Railroad Medicare Medicare |
$212.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$391.74
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$212.46
|
| Rate for Payer: UHC Exchange |
$391.74
|
| Rate for Payer: UHC Medicaid |
$138.02
|
| Rate for Payer: UHCCP DNSP |
$212.46
|
| Rate for Payer: UHCCP Medicaid |
$138.02
|
|
